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台风“海燕”对菲律宾东米沙鄢两所医院收治情况的影响。

The impact of Typhoon Haiyan on admissions in two hospitals in Eastern Visayas, Philippines.

作者信息

van Loenhout Joris Adriaan Frank, Gil Cuesta Julita, Abello Jason Echavez, Isiderio Juan Mari, de Lara-Banquesio Maria Lourdes, Guha-Sapir Debarati

机构信息

Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium.

Eastern Visayas Regional Medical Center, Tacloban, Philippines.

出版信息

PLoS One. 2018 Jan 30;13(1):e0191516. doi: 10.1371/journal.pone.0191516. eCollection 2018.

Abstract

OBJECTIVES

We investigated the short-term impact of Typhoon Haiyan, one of the strongest typhoons ever to make landfall, on the pattern of admissions in two hospitals in Eastern Visayas, the Philippines.

METHODS

This study took place at Eastern Visayas Regional Medical Center (EVRMC) in Tacloban, and Ormoc District Hospital (ODH) in Ormoc. We determined whether there were differences in the pattern of admissions between the week before and the three weeks after Haiyan by using information on sex, age, diagnosis, ward and outcome at discharge from patient records.

RESULTS

There was a drop in admissions in both hospitals after Haiyan as compared to before. Admissions climbed back to the baseline after ten days in EVRMC and after two weeks in ODH. When comparing the period after Haiyan to the period before, there was a relative increase in male versus female admissions in ODH (OR 2.8, 95%CI 1.7-4.3), but not in EVRMC. Patients aged ≥50 years and 0-14 years had the highest relative increase in admissions. There was a relative decrease in admissions for the ICD10 group 'Pregnancy, childbirth and the puerperium' (OR 0.4, 95%CI 0.3-0.6), and an increase in 'Certain infectious and parasitic diseases' (OR 2.1, 95%CI 1.2-3.5), mainly gastroenteritis, and 'Diseases of the respiratory system' (OR 1.8, 95%CI 1.0-3.0), mainly pneumonia, compared to all other diagnosis groups in ODH. Out of all reasons for admission within the study period, 66% belong to these three ICD-10 groups. Data on reasons for admission were not available for EVRMC.

CONCLUSIONS

The observed reduction in patients after the Typhoon calls for ensuring that hospital accessibility should be protected and reinforced, especially for pregnant women, by trying to remove debris in the direct hospital vicinity. Hospitals in areas prone to tropical cyclones should be prepared to treat large numbers of patients with gastroenteritis and pneumonia, as part of their disaster plans.

摘要

目的

我们调查了有史以来登陆的最强台风之一——海燕台风对菲律宾东维萨亚斯地区两家医院入院模式的短期影响。

方法

本研究在塔克洛班的东维萨亚斯地区医疗中心(EVRMC)和奥尔莫克的奥尔莫克地区医院(ODH)进行。我们通过使用患者记录中关于性别、年龄、诊断、病房和出院结局的信息,确定海燕台风来临前一周与过后三周的入院模式是否存在差异。

结果

与台风来临前相比,两家医院在海燕台风过后入院人数均有所下降。在EVRMC,十天后入院人数回升至基线水平;在ODH,两周后入院人数回升至基线水平。将海燕台风过后的时期与之前的时期进行比较时,ODH中男性入院人数相对于女性有所增加(比值比2.8,95%置信区间1.7 - 4.3),但在EVRMC中并非如此。年龄≥50岁和0 - 14岁的患者入院人数相对增加最多。与ODH中的所有其他诊断组相比,国际疾病分类第10版(ICD10)中“妊娠、分娩和产褥期”组的入院人数相对减少(比值比0.4,95%置信区间0.3 - 0.6),而“某些传染病和寄生虫病”(比值比2.1,95%置信区间1.2 - 3.5),主要是肠胃炎,以及“呼吸系统疾病”(比值比:1.8,95%置信区间1.0 - 3.0),主要是肺炎,入院人数有所增加。在研究期间所有入院原因中,66%属于这三个ICD - 10组。EVRMC没有关于入院原因的数据。

结论

台风过后观察到的患者人数减少情况要求确保医院的可达性应得到保护和加强,特别是对于孕妇,可尝试清除医院附近的残骸。易受热带气旋影响地区的医院应在其灾难计划中做好准备,以治疗大量肠胃炎和肺炎患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/487e/5790240/427972178618/pone.0191516.g001.jpg

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